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A-traction teсhnics for neglected mallet fracture

Oral report of Artur Bezuhlyi on FESSH ONline week 2020

Standard methods for treating of fresh mallet fracture with K-wires, screws and plates in neglected cases does not always give accurate reposition of fragments. Fragment removal with extensor terminal portion transossal suture to the distal phalanx significantly disrupts biomechanics and

stability of the distal interphalangeal joint and usually does not give satisfactory results. Our method is fundamentally different from others. It consists of an open fragment reposition using the guide wire and fixation by and compression loop and K-wire with memory effect. Steps: 1) Figured surgical exposure; 2) Separation of the fibrous fusion area of fragments, their mobilization and removal of fibrotic tissues; 3) Open reposition of the fragment by guide wire; 4) Carrying out the compression loop; 5) Fixation of the loop to the wire with memory effect with achievement of traction-compression effect. Proposed method was used in 17 patients (18 fingers) with closed, neglected mallet fracture. Consolidation with the restoration of anatomical congruence has occurred in all cases. Method is characterized by simplicity of implementation, lack of need for special tools and has

significant advantages - ability to fix small fragments, constant compression of the fragment and ease of disassembly design that does not require additional surgery, which in generally improves outcomes of neglected mallet fracture treatment.



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